Testing the Efficacy of a Culturally Adapted Family Dementia Caregiver Intervention (REACH VN): Results From a Cluster Randomized Controlled Trial in Northern Vietnam

Abstract

Objectives: Vietnam faces an unprecedented increase in people living with dementia but lacks evidence-based family dementia caregiver interventions. We tested the efficacy of a culturally adapted family caregiver intervention (REACH VN) in Northern Vietnam.

Methods: In this randomized controlled trial, clusters (communes) were assigned to¹ REACH VN (a multicomponent intervention consisting of 4-6 one-hour sessions delivered over 1-3 months) or² enhanced control (one session of dementia education). Primary outcomes were caregiver perceived psychological distress (PHQ-4) and burden (ZBI-12). Secondary outcomes were caregiver perceived stress (PSS-10) and somatic symptoms (PHQ-15). Mixed effects analysis was performed with 3-month and 6-month assessments as the outcomes and baseline assessment as a covariate.

Results: Overall, 350 caregivers from 40 clusters (21 intervention, 19 enhanced control) enrolled and 330 (94.3%) completed 3-month assessments. At 3 months, the REACH VN intervention group had lower PHQ-4 (p <0.001) but not ZBI-12 (p = 0.05) scores compared to control. At 6 months, the intervention group had lower ZBI-12 (p = 0.002) but not PHQ-4 (p = 0.5) scores. PSS-10 and PHQ-15 scores were also improved at 3 months (p = 0.007, p <0.001 respectively) for the REACH VN intervention group compared with control but not at 6 months.

Conclusions: REACH VN improved outcomes in family caregivers in Vietnam at 3 months although improvement was not sustained for most outcomes at 6 months.

Keywords: Alzheimer's disease; Dementia; Family caregiving; Global health; Low- and middle-income countries; Nonpharmacological interventions; Vietnam.